Provider Demographics
NPI:1184722852
Name:KENNEY, ANNE ELIZABETH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:KENNEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7197 RICKETT RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8249
Mailing Address - Country:US
Mailing Address - Phone:517-881-2110
Mailing Address - Fax:
Practice Address - Street 1:1200 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1007
Practice Address - Country:US
Practice Address - Phone:517-546-0200
Practice Address - Fax:517-546-4669
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704208273363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner